Technically Speaking: When It Comes to MenACWY, Join the “We Never Guess! We Look It Up” Club
Published on in Vaccine Update for Healthcare Providers
Published on in Vaccine Update for Healthcare Providers
As a third grader, I belonged to the “We Never Guess! We Look It Up” club. We were committed to using our new classroom encyclopedias (paper versions of Wikipedia) to get the facts. When, as a pediatric resident, I was asked about the immunization schedule, I did not have to look it up. I had it completely memorized — there were only three childhood vaccines. Now, when I need an answer to a complex immunization schedule question, I turn to the technically sophisticated clinical decision support in my electronic health record, my state’s immunization information system, or a nurse.
Where do nurses in the “We Never Guess” club find answers? Many are devotees of the Vaccine Education Center at CHOP, Immunize.org, and The Vaccine Handbook (also available for Android or iOS).
One of the vaccines that by necessity increases the “We Never Guess” club membership is meningococcal vaccine, specifically MenACWY. N. meningitidis causes a particularly destructive form of meningitis that often leaves patients with long-term neurologic conditions, including deafness, weakness or paralysis, fluid on the brain, or developmental delay. Even worse, it can cause an invasive syndrome that, even with prompt medical care, causes 15% to 20% death rates in affected adolescents and adults. This is one of the infections that emergency medicine physicians most fear overlooking and most fear finding.
While you probably know that all adolescents should have a 2-dose MenACWY vaccine series starting at 11–12 years of age with the booster at age 16, test your knowledge beyond these basics with the questions below. You can use the following weblinks if you want to join the “We Never Guess” club:
QUESTION #1: In addition to the routine recommendation for MenACWY vaccination of adolescents, there are risk-based recommendations for vaccination of some adults. Which of the following adults should receive MenACWY? (Choose all that apply)
Q1 Answer: The adults described in answers B and E should receive MenACWY. People living with HIV and military recruits should receive MenACWY. See this CDC webpage for more details.
Pneumococcal, but not meningococcal vaccination, is recommended for people with chronic heart, lung, liver, or renal disease; those who smoke cigarettes; and those who have a cerebrospinal fluid leak or cochlear implants. For more on pneumococcal vaccination recommendations, please see this CDC webpage.
QUESTION #2: The following students have no underlying health conditions. Which students should receive MenACWY at today’s appointment? (Choose all that apply)
Q2 Answer: A, C, and E need a MenACWY today.
QUESTION #3: Which of these patients should receive MenACWY at an appointment scheduled for today? (Choose all that apply)
Q3 Answer: The children described in answers A and D should receive MenACWY today.
If you answered the three questions correctly, congratulations! If you looked it up, you are now a member of the “We Never Guess” club.
Because MenACWY is underutilized, it is important to build systems that get patients protected against this life-altering infection. Try these mechanisms for improving your vaccine coverage rates:
In addition to daily attention in your patient flow, this periodic, focused approach to catch-up helps identify patients who “slipped through the cracks.” For more on this topic, please see Give2MenACWY.org.
When in doubt, if the patient before you might need this life-saving vaccine, never guess!
For an attractive and interactive web-based educational module on meningitis, check out the “Comprehensive Vaccine Education Program—From Training to Practice” on the Pediatric Infectious Disease Society or Society for Healthcare Epidemiology of America websites.
Contributed by: Sharon G. Humiston, MD, MPH, FAAP
Categories: Vaccine Update October 2021, Technically Speaking
Materials in this section are updated as new information and vaccines become available. The Vaccine Education Center staff regularly reviews materials for accuracy.
You should not consider the information in this site to be specific, professional medical advice for your personal health or for your family's personal health. You should not use it to replace any relationship with a physician or other qualified healthcare professional. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult your physician or, in serious cases, seek immediate assistance from emergency personnel.